Late structural alterations of cerebral white matter in long-term survivors of childhood leukemia
Late structural alterations of cerebral white matter in long-term survivors of childhood leukemia
复制标题
DOI：
10.1002/jmri.21364
复制
发表时间：
2008-06-01
影响因子：
4.4
通讯作者：
Gutjahr, Peter
中科院分区：
文献类型：
--
作者：
Dellani, Paulo R.;Eder, Stefan;Gutjahr, Peter
目的：探讨儿童时期急性淋巴细胞白血病（ALL）成年幸存者在放疗和化疗后正常脑灰质和白质晚期结构改变的存在和年龄依赖性。材料与方法：13例17-37岁，16-28年前接受过全脑放疗（18-24 Gy）和化疗的成年幸存者，进行前瞻性MR检查，包括弥散张量成像（DTI）。评估包括体积法、平均扩散系数（MD）和分数各向异性（FA）的计算，并将结果与年龄匹配的对照组进行比较。结果：DTI显示颞叶FA值（差异0.069个单位，P < 0.001）、海马FA值（差异0.033个单位，P < 0.001）、丘脑FA值（差异0.046个单位，P = 0.001）显著降低，并伴有白质体积明显减少（差异92 cm(3), P < 0.001）。MD的显著升高仅限于颞白质(差异为42 × 10（-6) mm(2)/s, P = 0.005）。全脑和额叶白质MD与生存者年龄的增加呈负相关（P < 0.01）。结论：在结构性白质改变方面，接受全脑放疗和化疗的儿童ALL成年长期幸存者明显表现出与对照组相同的总体年龄依赖性。需要后续研究来证实。
Purpose: To look for the presence and age-dependence of late structural alterations of otherwise normal-appearing cerebral gray and white matter after radiation and chemotherapy in adult survivors of acute lymphoblastic leukemia (ALL) during childhood.Materials and Methods: In a group of 13 adult survivors 17-37 years old, who had been treated by total brain radiation (18-24 Gy) and chemotherapy 16-28 years ago, prospective MR examinations including diffusion tensor imaging (DTI) were performed. Evaluation included volumetry, calculation of mean diffusivity (MD) and fractional anisotropy (FA), and comparison of results to an age-matched control group.Results: DTI showed significantly reduced FA values in the temporal lobes (difference of 0.069 units, P < 0.001), hippocampi (difference of 0.033 units, P < 0.001), and thalami (difference of 0.046 units, P = 0.001), which were accompanied by significant white matter volume loss (difference of 92 cm(3), P < 0.001). Significant elevations of MD were limited to the temporal white matter (difference of 42 X 10(-6) mm(2)/s, P = 0.005). Global and frontal white matter MD correlated negatively to increasing age of the survivors (P < 0.01).Conclusion: With regard to structural white matter alterations, adult long-term survivors of childhood ALL, who had received total brain radiation and chemotherapy, apparently show the same overall age dependence as controls. Follow-up studies are needed for confirmation.